Over 1 million children in the united States may have voice disorders, which can have a significant negative impact on scholastic performance, communicative effectiveness, social development, and self esteem. However, the true impact of voice disorders on the lives of children and the effectiveness of various interventions is unknown. In particular, the patient of parent perspective regarding treatment outcomes in childhood dysphonia management has not been systematically examined. In contrast to adult dysphonia, there are no published validated instruments for assessing childhood dysphonia. Because phonatory disorders in children may have lasting negative affects, studies geared toward the development of tools for assessing treatment outcomes appears crucial. The long-term goal of this research program is to understand the mechanisms of childhood dysphonia, to develop adequate methods of treatment, and to effectively assess treatment outcomes. The hypothesis of this preliminary study is that chronic dysphonia has a negative effect on the quality of life of children. The first aim of this proposed research is to develop a reliable, age-appropriate, and valid instrument for assessing voice-related quality of life in pediatric populations. Questionnaire items will be developed and tested for child reporting and parent proxy for the following age groups: Toddler (2-4), Young Children (5-7), School age (8-12) and Adolescent (13-18). The second aim is to determine the relationship of voice disorders in children to voice-related quality of life and perception of general health. A voice assessment, a validated pediatric general health outcome measure, and our voice function questionnaire will be completed in chronically hoarse children and non-dysphonic controls. Dysphonic children will also receive a laryngeal examination. This work will lead to the creation of a valid, reliable, and age-appropriate measure of voice-related quality of life in children and will elucidate the manner in which laryngeal and voice disruptions affect childrens' lives. Information gained in this preliminary study will lead to further research proposals by this new clinical investigator in the areas of behavioral treatment, use of medications, optimal duration of management and surgical indications for children with chronic dysphonia and laryngeal disease. This new instrument will have potentially wide use in the fields of speech/language pathology, otolaryngology, and education. Accordingly, this research addresses an important clinical issue, and is consistent with the mission and intent of the NIDCD and PAR-00-110.